5.hand Instruments For Operative Dentistry Hadouts 1z3
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Hand Instruments for Operative Dentistry Operative Dentistry Dent 335/343 Mohammad Atieh , BDS, MS
Introduction • Before the invention of rotary instruments, dentists used to cut cavities using sharp hand instruments. • The first pedal driven hand piece was invented in 1871. • However, hand instruments are still used today for specific purposes. https://i2.wp.com/www.millerdentalcare.com/wpcontent/s/2015/03/dental-drill-pedal-driven.jpg
By PeterEasthope - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=54397032
Nomenclature and Classification
Nib
or
Blade
Shank
Handle
Double-ended
Working end
Handles
“Fundamentals of Operative Dentistry.” iBooks.
Out of Balance VS Balanced • Balanced = stable doesn't rotate. • Also contra-angled term is used when the shank has ≥2 angles to align the working end within 2-3 mms of the axis of the handle.
“Fundamentals of Operative Dentistry.” iBooks.
Cutting Edges • Primary and Secondary
Sturdevant’s Art and Science of Operative Dentistry, 6th edition
“Fundamentals of Operative Dentistry.” iBooks.
Single Beveled Vs Bi-beveled (Double Beveled)
“Fundamentals of Operative Dentistry.” iBooks.
Nomenclature • Black named instruments based on: • Appearance / shape. • Function /use • Number of angles
• For cutting instruments he also gave a 3 or 4-number formula (e.g.15-95-10-7)
Based on the Appearance • Examples: • Hatchets • Hoes • Spoons • Chisels
Hatchets
Hoes
www.hu-friedy.com
Spoons
www.hu-friedy.com
Chisels
www.hu-friedy.com
Based on the function • Examples: • Excavators • Gingival margin trimmers • Condensers • Carvers • Burnishers
Based on the Number of Shank Angles • Straight • Monangle • Binangle • Triple-angle • Quadrangle
“Fundamentals of Operative Dentistry.” iBooks.
Classification • There are different classifications available. The easiest one is the one that classifies hand instruments to cutting and noncutting.
Cutting Instruments
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators
Spoon Excavators • The blade has: • A circular (called regular) or disk shape ( called discoid) • Outer convexity and inner concavity. • Double-ended (left cutting and right cutting) • Usage: • Soft caries removal. • Evaluating the hardness of dentine (to evaluate the presence any remaining caries).
Spoons
www.hu-friedy.com
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets
Finishing cavity margins and removing uned enamel
Hatchets Binangle hatchet
Monagnle hatchet
“Fundamentals of Operative Dentistry.” iBooks.
Hatchets Double-Ended Left-cutting end
Right-cutting end
Off-Angle Hatchet A term used when the working end is not perpendicular to the blade.
www.hu-friedy.com
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels
Chisels • Has a blade that is either aligned with handle
www.hu-friedy.com
Chisels • Or slightly angled or curved form the long axis
www.hu-friedy.com
The chisel has a cutting edge at right angle to the long axis of the handle
Chisels
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels • Hoes
Hoes • Has a cutting edge at right angle to the handle like the chisel. • But the blade has a greater angle from the long axis of the handle than the chisel ( more than 45-degree). • They are used mainly for removing uned enamel and sharping walls of anterior cavity preparations.
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels • Hoes • Gingival margin trimmers
Gingival Margin Trimmers • Like a hatchet, but the blade is curved. • The bevel of the blade is always at the outside part of the curve and the face is inside part of the curve.
www.hu-friedy.com
Gingival Margin Trimmers • Comes in pairs: • Double ended mesial margin trimmer (Left cutting and right cutting ends). • Double ended distal margin trimmer (Left cutting and right cutting).
“Fundamentals of Operative Dentistry.” iBooks.
Distal
Mesial
www.hu-friedy.com
Strokes • Vertical (Chopping) or horizontal (Lateral scarping): • Like gingival margin trimmers and hatchets.
• The lateral scarping is carried out from the beveled to the the non-beveled side. This way is more effective in removing all uned enamel without missing the corners.
“Fundamentals of Operative Dentistry.” iBooks.
Strokes • Pulling or pushing stokes • Like hoes.
Sturdevant’s Art and Science of Operative Dentistry, 6th edition
Mesial bevel Push stroke
Distal bevel Pull stroke
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels • Hoes • Gingival margin trimmers • Carvers
Carvers • To shape amalgam and other toothcolored restorative materials after placement into the preparation.
Hollenback For occlusal and proximal anatomy
Amalgam Knife -For proximal anatomy and embrasures of posterior teeth. -F/L anatomy of posterior teeth. Discoid Cleoid -Mainly for occlusal anatomy -Discoid part is useful for lingual concavities on anterior teeth Premier USA
Premier USA
Numeric Formula
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm.
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm. • Second number = length of the blade in mm.
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm. • Second number = length of the blade in mm. • Third number = angle of the blade with the long axis of the handle in centigrades.
Centigrade Scale • Based on a circle divided into 100 units. • Right angle has 25 centrigrades.
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm. • Second number = length of the blade in mm. • Third number = angle of the blade with the long axis of the handle in centigrades.
14
Numeric Formulas • 4-Number formula • When primary cutting edge is not at right angle to the long axis of the blade:
4- Number Formulas • This additional number is located in the second place of the formula: • 15-95-10-7 • First number = Width of the blade in 0.1 mm. • Second number = Angle of the cutting edge with the long axis of the handle. • Third number = Length of the blade in mm. • Fourth number = Angle of the blade with the long axis of the handle in centigrades.
Non-Cutting Instruments
Non-Cutting Instruments • They don’t cut tooth structure or restorative material. • Examples : • Diagnostic instruments
Diagnostic Basic set
www.hu-friedy.com
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for Amalgam restorations : • Amalgam carriers
Double-ended Universal
www.hu-friedy.com
Amalgam Carriers • Carry amalgam and pushes it out into the preparation.
Amalgam well
Dappen dish
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments used for amalgam restorations : • carriers • Condensers
Condensers • They condense (compress) amalgam into the preparation. • They are also used to push other restorative materials like composite and glass-ionomer into the preparation ( Those materials don’t need high condensation force like amalgam).
Condensers • Nibs come in different shapes and sizes: • Shapes: • • • •
Round ( as shown in the picture). Triangular Rectangular Diamond shaped
Back Action (Triple Angle Condenser) • A special type. • Helps in condensing amalgam into distal surfaces of teeth by applying the force towards the operator (back action).
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments used or amalgam restorations : • carriers • Condensers • Burnishers
Acorn burnisher
FOOTBALL-SHAPED END
BALL-SHAPED END
www.hu-friedy.com
Burnishers • Burnish means to make shiny (polish) metal by rubbing. • They are used to burnish freshly placed amalgam to make the surface smoother.
• Burnishing also involves pinching off material edges. This is useful in closing the margin of freshly place amalgam. • Burnishers are also used to sculpt occlusal anatomy in posterior resin composite restorations prior to polymerization.
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for amalgam restorations : • carriers • Condensers • Burnishers
• Instruments for composite restorations: • Plastic filling instruments
Plastic Filling Instruments • They are named as that because they were originally design to place ”plastic” non-metal restorative materials like acrylic resins and silicates. • They are used now used to place tooth-colored restorative materials like resin composites and glassionomer restorations; and temporary restorative materials.
Hu Friedy Restorative Catalogue
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for amalgam restorations : • carriers • Condensers • Burnishers
• Instruments for composite restorations: • Plastic filling instruments
• Placement instruments • Calcium hydroxide applicator
Calcium Hydroxide Applicator • To apply calcium hydroxide, glass-ionomer and other liners into the cavity preparation.
Hu Friedy Restorative Catalogue
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for amalgam restorations : •
carriers
•
Condensers
•
Burnishers
• Instruments for composite restorations: •
Plastic filling instruments
• Placement instruments •
Calcium hydroxide applicator
• Mixing Spatulas
Hu Friedy Restorative Catalogue
Lecture References • “Fundamentals of Operative Dentistry.” iBooks. • Sturdevant’s Art and Science of Operative Dentistry, 6th edition.
Study Reference • From the handouts.
Weeded Quiz • There will be no quiz!. Enjoy!. But study this lecture and the lab material the I will post online to prepare you for the next exercise.
• Useful YouTube video: • https://www.youtube.com/watch?v=7xdqaGfa1b8
Introduction • Before the invention of rotary instruments, dentists used to cut cavities using sharp hand instruments. • The first pedal driven hand piece was invented in 1871. • However, hand instruments are still used today for specific purposes. https://i2.wp.com/www.millerdentalcare.com/wpcontent/s/2015/03/dental-drill-pedal-driven.jpg
By PeterEasthope - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=54397032
Nomenclature and Classification
Nib
or
Blade
Shank
Handle
Double-ended
Working end
Handles
“Fundamentals of Operative Dentistry.” iBooks.
Out of Balance VS Balanced • Balanced = stable doesn't rotate. • Also contra-angled term is used when the shank has ≥2 angles to align the working end within 2-3 mms of the axis of the handle.
“Fundamentals of Operative Dentistry.” iBooks.
Cutting Edges • Primary and Secondary
Sturdevant’s Art and Science of Operative Dentistry, 6th edition
“Fundamentals of Operative Dentistry.” iBooks.
Single Beveled Vs Bi-beveled (Double Beveled)
“Fundamentals of Operative Dentistry.” iBooks.
Nomenclature • Black named instruments based on: • Appearance / shape. • Function /use • Number of angles
• For cutting instruments he also gave a 3 or 4-number formula (e.g.15-95-10-7)
Based on the Appearance • Examples: • Hatchets • Hoes • Spoons • Chisels
Hatchets
Hoes
www.hu-friedy.com
Spoons
www.hu-friedy.com
Chisels
www.hu-friedy.com
Based on the function • Examples: • Excavators • Gingival margin trimmers • Condensers • Carvers • Burnishers
Based on the Number of Shank Angles • Straight • Monangle • Binangle • Triple-angle • Quadrangle
“Fundamentals of Operative Dentistry.” iBooks.
Classification • There are different classifications available. The easiest one is the one that classifies hand instruments to cutting and noncutting.
Cutting Instruments
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators
Spoon Excavators • The blade has: • A circular (called regular) or disk shape ( called discoid) • Outer convexity and inner concavity. • Double-ended (left cutting and right cutting) • Usage: • Soft caries removal. • Evaluating the hardness of dentine (to evaluate the presence any remaining caries).
Spoons
www.hu-friedy.com
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets
Finishing cavity margins and removing uned enamel
Hatchets Binangle hatchet
Monagnle hatchet
“Fundamentals of Operative Dentistry.” iBooks.
Hatchets Double-Ended Left-cutting end
Right-cutting end
Off-Angle Hatchet A term used when the working end is not perpendicular to the blade.
www.hu-friedy.com
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels
Chisels • Has a blade that is either aligned with handle
www.hu-friedy.com
Chisels • Or slightly angled or curved form the long axis
www.hu-friedy.com
The chisel has a cutting edge at right angle to the long axis of the handle
Chisels
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels • Hoes
Hoes • Has a cutting edge at right angle to the handle like the chisel. • But the blade has a greater angle from the long axis of the handle than the chisel ( more than 45-degree). • They are used mainly for removing uned enamel and sharping walls of anterior cavity preparations.
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels • Hoes • Gingival margin trimmers
Gingival Margin Trimmers • Like a hatchet, but the blade is curved. • The bevel of the blade is always at the outside part of the curve and the face is inside part of the curve.
www.hu-friedy.com
Gingival Margin Trimmers • Comes in pairs: • Double ended mesial margin trimmer (Left cutting and right cutting ends). • Double ended distal margin trimmer (Left cutting and right cutting).
“Fundamentals of Operative Dentistry.” iBooks.
Distal
Mesial
www.hu-friedy.com
Strokes • Vertical (Chopping) or horizontal (Lateral scarping): • Like gingival margin trimmers and hatchets.
• The lateral scarping is carried out from the beveled to the the non-beveled side. This way is more effective in removing all uned enamel without missing the corners.
“Fundamentals of Operative Dentistry.” iBooks.
Strokes • Pulling or pushing stokes • Like hoes.
Sturdevant’s Art and Science of Operative Dentistry, 6th edition
Mesial bevel Push stroke
Distal bevel Pull stroke
Cutting instruments • They cut tooth structure or restorative material • Examples : • Spoon excavators • Hatchets • Chisels • Hoes • Gingival margin trimmers • Carvers
Carvers • To shape amalgam and other toothcolored restorative materials after placement into the preparation.
Hollenback For occlusal and proximal anatomy
Amalgam Knife -For proximal anatomy and embrasures of posterior teeth. -F/L anatomy of posterior teeth. Discoid Cleoid -Mainly for occlusal anatomy -Discoid part is useful for lingual concavities on anterior teeth Premier USA
Premier USA
Numeric Formula
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm.
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm. • Second number = length of the blade in mm.
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm. • Second number = length of the blade in mm. • Third number = angle of the blade with the long axis of the handle in centigrades.
Centigrade Scale • Based on a circle divided into 100 units. • Right angle has 25 centrigrades.
Numeric Formulas • 3-Number formula: • When primary cutting edge at right angle to the long axis of the blade: • First number = width of the blade in 0.1 mm. • Second number = length of the blade in mm. • Third number = angle of the blade with the long axis of the handle in centigrades.
14
Numeric Formulas • 4-Number formula • When primary cutting edge is not at right angle to the long axis of the blade:
4- Number Formulas • This additional number is located in the second place of the formula: • 15-95-10-7 • First number = Width of the blade in 0.1 mm. • Second number = Angle of the cutting edge with the long axis of the handle. • Third number = Length of the blade in mm. • Fourth number = Angle of the blade with the long axis of the handle in centigrades.
Non-Cutting Instruments
Non-Cutting Instruments • They don’t cut tooth structure or restorative material. • Examples : • Diagnostic instruments
Diagnostic Basic set
www.hu-friedy.com
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for Amalgam restorations : • Amalgam carriers
Double-ended Universal
www.hu-friedy.com
Amalgam Carriers • Carry amalgam and pushes it out into the preparation.
Amalgam well
Dappen dish
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments used for amalgam restorations : • carriers • Condensers
Condensers • They condense (compress) amalgam into the preparation. • They are also used to push other restorative materials like composite and glass-ionomer into the preparation ( Those materials don’t need high condensation force like amalgam).
Condensers • Nibs come in different shapes and sizes: • Shapes: • • • •
Round ( as shown in the picture). Triangular Rectangular Diamond shaped
Back Action (Triple Angle Condenser) • A special type. • Helps in condensing amalgam into distal surfaces of teeth by applying the force towards the operator (back action).
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments used or amalgam restorations : • carriers • Condensers • Burnishers
Acorn burnisher
FOOTBALL-SHAPED END
BALL-SHAPED END
www.hu-friedy.com
Burnishers • Burnish means to make shiny (polish) metal by rubbing. • They are used to burnish freshly placed amalgam to make the surface smoother.
• Burnishing also involves pinching off material edges. This is useful in closing the margin of freshly place amalgam. • Burnishers are also used to sculpt occlusal anatomy in posterior resin composite restorations prior to polymerization.
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for amalgam restorations : • carriers • Condensers • Burnishers
• Instruments for composite restorations: • Plastic filling instruments
Plastic Filling Instruments • They are named as that because they were originally design to place ”plastic” non-metal restorative materials like acrylic resins and silicates. • They are used now used to place tooth-colored restorative materials like resin composites and glassionomer restorations; and temporary restorative materials.
Hu Friedy Restorative Catalogue
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for amalgam restorations : • carriers • Condensers • Burnishers
• Instruments for composite restorations: • Plastic filling instruments
• Placement instruments • Calcium hydroxide applicator
Calcium Hydroxide Applicator • To apply calcium hydroxide, glass-ionomer and other liners into the cavity preparation.
Hu Friedy Restorative Catalogue
Non-Cutting • They don’t cut tooth structure • Examples : • Diagnostic instruments • Instruments Used for amalgam restorations : •
carriers
•
Condensers
•
Burnishers
• Instruments for composite restorations: •
Plastic filling instruments
• Placement instruments •
Calcium hydroxide applicator
• Mixing Spatulas
Hu Friedy Restorative Catalogue
Lecture References • “Fundamentals of Operative Dentistry.” iBooks. • Sturdevant’s Art and Science of Operative Dentistry, 6th edition.
Study Reference • From the handouts.
Weeded Quiz • There will be no quiz!. Enjoy!. But study this lecture and the lab material the I will post online to prepare you for the next exercise.
• Useful YouTube video: • https://www.youtube.com/watch?v=7xdqaGfa1b8
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